The Changing Face of Diabetes
Your body needs glucose (blood sugar) for energy. But having too much of it over time can cause serious health problems.
- With Type 1 diabetes, the body doesn’t make insulin, a hormone needed to help get glucose into the body’s cells for energy. It is an autoimmune disease (when the body mistakenly attacks itself) and is usually diagnosed in children, teens, or young adults. People with Type 1 diabetes need to take insulin daily. About 5% of people with diabetes have Type 1.
- With Type 2 diabetes, the body has trouble using insulin. This type of diabetes usually affects people who are middle-aged or older, but it is seen more often in children now as well. About 90% of people with diabetes have Type 2.
- Other types of diabetes include gestational diabetes, which affects pregnant women.
- Prediabetes is when a person’s blood sugar levels are high, but not high enough to be diagnosed with diabetes. Having prediabetes increases the risk for heart disease, stroke, or Type 2 diabetes.
Diabetes affects more than 30 million Americans and more than 400 million people worldwide. Many people with Type 2 diabetes (as many as 1 in 4) don’t know they have it.
You can prevent or delay having Type 2 diabetes by eating a healthy diet, getting regular exercise, avoiding tobacco smoke, and losing weight (if you’re overweight). If lifestyle changes aren’t enough, your doctor may also prescribe medication. Currently, no one knows how to prevent Type 1 diabetes. Clinical research is growing our understanding of diabetes and how to treat it. Read on to learn more.
If you are living with diabetes, we would like to hear from you.
- Please tell us about your experience living with diabetes in our brief online survey.
- At the end of the survey, you can sign up to be considered for an upcoming clinical trial.
- We also invite you to join our online patient community and connect with others about diabetes.
Thank you for sharing with us.
Who is at risk for diabetes?
Risk factors for Type 2 diabetes include:
- Age (being 45 or older)
- Having a family history of diabetes
- Being overweight
- Lack of physical activity
- Race/ethnicity: African Americans, Hispanic/Latino Americans, American Indians, or Alaska Natives (some Pacific Islanders and Asian Americans are also at higher risk)
- Having certain health problems such as high blood pressure
- Previously having gestational diabetes when you were pregnant
Risk factors for Type 1 diabetes include:
- Family history: Having a parent, brother, or sister with Type 1 diabetes
- Race/ethnicity: In the United States, whites are more likely to develop Type 1 diabetes than African Americans and Hispanic/Latino Americans.
- Age: You can get Type 1 diabetes at any age, but it’s more likely to develop when you’re a child, teen, or young adult
What are the symptoms of diabetes?
- Symptoms of Type 1 diabetes include frequent urination, thirst, constant hunger, weight loss, vision changes, and fatigue. These symptoms may start suddenly.
- Type 2 diabetes symptoms may be similar, but much less noticeable. It may not be diagnosed for several years, after complications have arisen.
What are the possible health problems due to diabetes?
Over time, high blood glucose can lead to problems such as:
- heart disease
- kidney disease
- eye problems
- dental disease
- nerve damage
- foot problems
How is diabetes diagnosed?
Doctors test for diabetes with a blood test. The blood tests show if your blood glucose (also called blood sugar) is too high.
- A fasting plasma glucose test (FPG) tells your blood glucose level at a single point in time. Usually you must fast for 8 hours or more (no eating or drinking, except small sips of water).
- The A1C test tells your average glucose level over 3 days. The results are given as a percentage.
- A random plasma glucose (RPG) test is sometimes used when symptoms are present and diabetes is suspected. It does not require fasting and can be done at any time.
- The oral glucose tolerance test (OGTT) measures your blood glucose after fasting for 8 hours. First, your blood is drawn, and then you drink a liquid containing glucose. Your blood is then drawn again every hour for the next 2 or 3 hours.
- A glucose challenge test may be used to detect gestational diabetes. It involves drinking a liquid containing glucose and then drawing your blood an hour later. If your blood glucose is too high, you may need to have additional testing.
How is diabetes treated?
People with Type 1 diabetes need insulin, which helps control blood glucose. It is given by injection, but can also be delivered with an insulin pump, which is a small computerized device.
For Type 2 diabetes, lifestyle changes are the first approach. These changes include:
- A healthy diet that is low in fat and includes vegetables, whole grains, fruits, and lean meats or meat substitutes
- Regular exercise (at least 30 minutes most days of the week)
- Avoiding tobacco smoking
- Limiting alcohol
- Keeping a healthy weight
- Managing other related risk factors, such as high blood pressure
If you are unable to lower your blood sugar with lifestyle changes alone, your doctor may prescribe additional treatment, as needed, such as:
- Insulin (sometimes given to people with Type 2 diabetes to help lower their blood glucose)
- Oral medication (examples below)
- Sulfonylureas, which stimulate cells of the pancreas to release more insulin.
- Biguanides, which lower blood glucose levels by decreasing the amount of glucose produced by the liver. They also help to make muscle tissue more sensitive to insulin so glucose can be absorbed. Metformin is a biguanide.
- Meglitinides, which stimulate cells in the liver to release insulin.
- Thiazolidinediones, which help insulin work better in the muscle and fat and also reduce glucose production in the liver. Although they generally have few side effects, they are being monitored closely for any effects on the liver and heart.
- DPP-4 inhibitors, which help improve A1C without causing low blood glucose. They work by preventing the breakdown of a naturally occurring compound in the body called GLP-1.
- SGLT2 Inhibitors, which work in the kidneys to reabsorb glucose or cause excess glucose to be eliminated in the urine.
- Alpha-glucosidase inhibitors, which help the body to lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine. They also slow the breakdown of some sugars. This slows the rise in blood glucose levels after a meal.
- Bile acid sequestrants, which are cholesterol-lowering medications that also reduce blood glucose levels. They help remove cholesterol from the body, particularly LDL cholesterol, which is often elevated in people with diabetes.
- Oral combination therapy, which involves using different types of medicines together to help lower blood glucose levels in different ways.
- Blood pressure control
- Foot care
- Screening and treatment for retinopathy (which causes blindness)
- Blood lipid control (to manage cholesterol levels)
- Screening for early signs of diabetes-related kidney disease and treatment
Clinical Trials - Learn More
Clinical trials are helping medical researchers better understand diabetes and how to treat it. Finding these answers depends on people like you to take part.
Have you considered taking part in a clinical trial for people with diabetes?
Potential benefits of participating in a clinical trial include:
- Close care and monitoring by a study doctor and staff throughout the study
- No cost for study treatment, related tests and procedures
- Contribute to our understanding of the treatment options for diabetes
If you would like to be considered for an upcoming clinical trial in diabetes, take our survey.
Please take some time to answer a few questions and be considered for an upcoming clinical trial for people with diabetes. We also invite you to join our patient community.
Thank you for sharing with us.
If you would like to be notified about an upcoming clinical trial in diabetes, you may sign up at the end of our survey.